Inspection on 29/11/06 for Allerton Avenue

This inspection was carried out on 29th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Allerton Avenue 21/11/08

Allerton Avenue 21/02/06

Allerton Avenue 20/09/05

Allerton Avenue 07/03/05

Allerton Avenue 24/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Allerton Avenue 3 Allerton Avenue Moortown Leeds West Yorkshire LS17 6RE Lead Inspector Sue Dunn Key Unannounced Inspection 29th November 2006 13:20 DS0000001411.V310606.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000001411.V310606.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000001411.V310606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allerton Avenue Address 3 Allerton Avenue Moortown Leeds West Yorkshire LS17 6RE 0113 288 8577 0113 2888577 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.c-i-c.co.uk. Community Integrated Care Mr Paul Cordy Care Home 4 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (2) of places DS0000001411.V310606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 2 places for LD(E) are for the service users named in connection with the variation application December 2003 21st February 2006 Date of last inspection Brief Description of the Service: Allerton Avenue is a large detached house in an area of similar houses in a suburb of Leeds close to local shops and a bus route into the city centre. The home provides residential care for up to four male and female adults with learning disabilities. The home does not provide nursing care. The communal lounge and dining room, separate kitchen and laundry are on the ground floor. Bedrooms on the first floor are of a good size and all are single. There is no lift access to the first floor. The house has a large well-maintained garden and on road parking. All the housemates share the house car. DS0000001411.V310606.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the inspection visit was to ensure the home was operating and being managed for the benefit and well being of the service users. One inspector undertook the inspection, which was unannounced. The inspection started at 13.20 pm and finished at 5.25 pm. A pre inspection questionnaire had been completed and returned by the manager and was used to support judgements made during the inspection visit. The report is based on information received from the home since the last inspection in February 2006, observation and conversation with service users, staff and an advocate, examination of documentation including 2 care files (which were tracked), and an inspection of the premises. Survey forms had been completed, with the assistance of independent advocates, and returned by all the people living in the home The weekly fee for the home is £803.38. The services not included in the fee are hairdressing, personal clothing and toiletries, social activities, holidays and transport. All requirements from the last inspection report had been met. The inspector would like to thank the people living in the house and the staff for their assistance and helpful comments during the inspection visit. DS0000001411.V310606.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Medication in cream and lotion form is now individually prescribed and safely stored. The porch window frames had been replaced with PVC, and this area was free from the clutter found on the previous visit. Roller blinds had been fitted to the windows in the bathroom and toilet areas to improve privacy. DS0000001411.V310606.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000001411.V310606.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000001411.V310606.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality outcomes in this area were good. The judgement was based on all the available evidence, which included examination of documentation and discussion with staff. Staff had arranged the information in the guide in a series of pictures. This made the guide colourful and attractive. The wording of some of the information however could be have been made more simple to make it understandable to people not in the care profession. EVIDENCE: The service user guide was pictorial and colourful. However, the language could have been simplified to make it more understandable to users of the service and people not working in the care industry. There had been no admissions to the home since the last inspection but the guide gave a detailed description explaining that people have a number of visits and overnight stays in the home before moving in for a three-month trial period. A copy of the terms and conditions of occupancy for one person was seen. This had been signed by a relative. The information included the weekly charge for use of the vehicle. This was seen in one of the service user agreements to be £16.50 DS0000001411.V310606.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, examination of documentation, discussion with service users and staff and observation. The care file documentation gave a clear picture of each person’s needs, their involvement and a plan of how the needs were to be met. The recording on a day-to-day basis was better in some files than others. EVIDENCE: The inspector was met at the gate by one of the ladies. Two care files were inspected. Both were consistent in layout including a life story book containing photographs and life history, which was ongoing, a daily diary, a health care file and care plans which were reviewed monthly. Each contained a recent clear photograph. All documents were written in the first person to include the views of the service user. Reviews recapped on the achievements and activities of the previous month and set achievable goals for the coming month. The review forms were set out under pictorial headings and covered Health, clothes, money and activities. DS0000001411.V310606.R01.S.doc Version 5.2 Page 11 Entries in the daily diaries gave a brief description of events. One diary was better than the other as it gave details of the action taken to show goals had been carried through. One person had been shopping but the daily records did not refer to the care plan goals. Discussion with service users, inspection of the latest review notes and observation however clearly demonstrated that people were being supported to achieve their wishes. Staff said that as the staff group was small, communication was good and this sort of information would have been shared verbally. Risk assessments were dated but in one file went back to 2001. There was no indication these had been reviewed and remained the same, though this had been done in the other file. Notes of an annual review meeting showed the service user attended and was able to express his views. One person said he liked living in the home and gets on with his housemates. A senior support worker said staff were thinking ahead to when the people in the house would have difficulty managing the stairs. The organisation had given authorisation to look for bungalows. It was clear service users were aware of this. Staff were helping one person to build a friendship with a person with similar needs in one of the other homes who might be a possible future housemate. DS0000001411.V310606.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 14, 15, 16 and 17 Quality in this outcome area was excellent. This judgement was based on all the available evidence including a visit to the service. Service users were supported to lead fulfilling lives according to their interests and circumstances. EVIDENCE: It was evident from speaking to staff, reading life plans and observing service users that a couple of people in the home have a long standing friendship. Staff said they offer support for other people in the home to develop friendships outside based on similarities. There was a friendly and affectionate relationship observed between service users and the staff. Everyone had returned a survey form completed with the help of an advocate and all said they were very happy living in the home. Care files written in the first person gave each person the opportunity to express their wishes regarding social and recreational activities. Two people were assisted to get ready to go out to a dancing group in the evening. Both were wearing stylish clothes, which suited them. One was wearing a pair of new boots, which she was pleased to show off. DS0000001411.V310606.R01.S.doc Version 5.2 Page 13 On the same day one person had been to an art group, another to a training centre and another to TACT, arriving home at teatime just as the visit was ending. One person spent some time telling the inspector about a holiday in Cornwall, showing off his bedroom and his picture board diary. He said he helped with the food shopping and liked living in the home. His favourite food, pizza, was on the menu for Monday. Staff receive food hygiene training and were preparing a cooked evening meal. DS0000001411.V310606.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 Quality in this outcome area is excellent. This judgement was based on all the available evidence including a visit to the service. Records provided staff with clear guidance about each service users preferences and allowed all aspects of care to be easily tracked. EVIDENCE: Each person had a separate Health Care plan which could only be read with the permission of the person concerned. In the two files examined it was clear from reading the notes that peoples’ right to refuse was respected. For example, one person had chosen not to go to day care on occasions and refused medical check ups. The plans were written in the first person with the support of a key worker. Each medication prescribed was on a separate sheet, stating what it was for and possible side effects Staff were alert and supportive of a person who had seasonal depression. Files included details of dental, feet, eye, hearing, routine health checks and weight monitoring. Risk assessments were reviewed and dated and there was very good guidance for staff on how to respond to one person’s behaviour. This however was dated 2002 with no evidence that it was reviewed, effective, and still being used. Personal care instructions and a summary of health care appointments were recorded in the file and there was evidence that key-workers liaised with DS0000001411.V310606.R01.S.doc Version 5.2 Page 15 psychiatrists and other health professionals on behalf of each service user to ensure they received the correct support. Entries in daily diaries varied; there was some very informative recording of information whereas in another case staff had not recorded their own intervention when describing someone as ‘acting out’. A support worker was observed giving medication. She said all staff had medication training in 2005 at a local college and received 6 monthly in house medication assessments Creams and lotions are now individually prescribed and all medication is held in a locked cabinet. DS0000001411.V310606.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, examination of documentation, discussion with service users and two independent advocates. The complaints procedure could be improved by using the same pictorial format as is used in the service user guide. EVIDENCE: A copy of the complaints procedure was seen at the back of the service user guide. This could be improved by using the same pictorial approach as used elsewhere in the service user guide to make it easier for service users to understand. All the service users had been assisted to complete the CSCI comment leaflet and all ticked the box to say they had no understanding of the complaints procedure. However, one person said they would ‘speak to a friend’ if they had any concerns. Two independent advocates spoken with after the visit said the people they supported were ‘ happier than they have ever been’. The staff recruitment and selection process requires all staff to have Protection of Vulnerable Adult and Criminal Record Bureau checks (POVA and CRB). DS0000001411.V310606.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service, discussion with service users advocates and staff, examination of documentation and observation. The environment is clean, warm, well furnished and ‘homely’. There are plans to ensure the long-term needs of service users can continue to be met as they get older. EVIDENCE: There is a very ‘homely’ environment in the home, which is indistinguishable from other houses on the street. The main communal rooms were large, retaining their original features, and all areas were warm, well furnished and decorated. A maintenance book used to record any repairs also showed when work had been completed. Two people gave permission for their rooms to be seen. Both had lots of space for pictures and personal possessions and had been decorated with the tastes of each person in mind. A bath chair had been installed in the bathroom after an occupational therapy assessment, to make bathing easier for service users. DS0000001411.V310606.R01.S.doc Version 5.2 Page 18 Roller blinds were fitted to the windows in the bathroom and toilet areas. The house was clean with no unpleasant smells. All the surveys returned to the CSCI commented on the high standard of cleanliness. The porch window frames had been replaced with PVC, and this area was free from the clutter found on the previous visit. The laundry was used as an area to hang coats but the door was kept closed. The steep staircase in the house was becoming less easy for people to manage as they aged. One of the advocates was concerned about this. However, staff had recognised the longer-term problems as housemates age and were looking for suitable bungalow accommodation. One service user was certainly aware of this plan and involved in the process. DS0000001411.V310606.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence, which included information from the pre inspection questionnaire, examination of documentation, discussion with staff, service users and advocates and observation. The home follows a thorough recruitment and selection procedure followed by a good programme of training, which ensures staff are competent and confident to meet the needs of the service users. EVIDENCE: Staff rotas take account of the needs and activities of the service users. There are normally two staff on each shift with an overlap of three at times as was seen on the day of the visit as not all staff can drive the house car. One staff file was checked. It included a fully completed application form, two written references, notes of the interview assessments by both interviewers and a candidate interview questionnaire. There was a clear colour photo, a copy of a birth certificate and the results of a POVA check in the file A three monthly assessment form had been signed by the assessor and the employee, who was given the opportunity to express his views about his progress. DS0000001411.V310606.R01.S.doc Version 5.2 Page 20 Formal supervision forms had been completed. These were relevant to work carried out and included discussions about the care needs of the service users. A diary was completed to cover all the topics on the six-week induction training. Certificates of completion in the file showed the following training had been covered: - Health and Safety, Food Hygiene, Principles of care, Personal care planning, and Moving and Handling. Other training planned programme. A support worker said staff were doing dementia training at a local college and had been taught some basic signs by accompanying a service user to the Leeds Centre for the deaf. Staff appeared competent and confident. There was a friendly relaxed atmosphere between staff and service users. The small staff team were familiar with the diverse preferences and needs of service users, which added to the ‘family’ feel of the home. DS0000001411.V310606.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service, discussion with staff and service users, observation and examination of documentation. The management arrangements in the manager’s absence were clear and all staff well informed and aware of their responsibilities. Systems were in place for maintaining a satisfactory level of health and safety. EVIDENCE: The manager who is experienced and qualified was on annual leave therefore a senior support worker assisted with the inspection visit. Formal staff meetings are held monthly. The minutes of the November meeting were inspected and showed staff were informed about changes in CSCI inspections, finances, Health and Safety and plans for the service users future. Discussion and information about service users needs was all recorded on separate sheets to comply with data protection. DS0000001411.V310606.R01.S.doc Version 5.2 Page 22 The records of money spent by, or on behalf of, service users was well recorded with receipts for any purchases. This, it was said, was checked at every staff handover. A full fire drill took place on 10/09/06 and records showed evidence of update fire lectures and weekly in house safety checks. The annual fire risk assessment was done in October. Records were up to date for routine checks on the emergency lighting system, the fire alarm system, water, electrical appliances, gas and electrical wiring. DS0000001411.V310606.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 4 26 3 27 3 28 4 29 3 30 4 STAFFING Standard No Score 31 4 32 3 33 3 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 x 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 3 4 3 3 3 3 3 x DS0000001411.V310606.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA1 YA6 YA41 YA41 YA22 YA41 Good Practice Recommendations The written information in the service user guide should be free from jargon. Daily records should include information about the progress of each person’s monthly goals Risk assessment reviews should be clearly dated to show the risk management plan remains relevant and effective The complaints procedure could be improved by including pictures and symbols DS0000001411.V310606.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000001411.V310606.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!